| NPI | 1700973815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery Surgical Critical Care (Licence: NC 2018-01811) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-01811) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2023-12-18 |